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Medical student SETs troubled teens on the right path

"I've told you that all along! Why didn't you listen to me?" That lament is all too familiar to the parents of teenagers. But the answer to the rhetorical question is obvious. Teens are more apt to heed advice from someone close to their own age than from ancient, out-of-touch parents.

A prematurely wise secondyear Dartmouth medical student has found a way to use that fact of life to help both at-risk teens and her fellow medical students. With the aid of a grant from the Albert Schweitzer Fellowship, Katrina Mitchell has developed a program called Substance Education for Teens (SET). It pairs adolescents arrested on alcohol or drug charges with medical student mentors.

Medical student Katrina Mitchell used a Schweitzer grant to help local teens.

Court: "Teenagers who are arrested in Hanover for shoplifting, drinking, marijuana, or any number of offenses," Mitchell explains, "can be referred to the Hanover Juvenile Diversion Committee rather than going through the court system. They meet with the committee and talk to counselors and do some reflection on their experience." The sentences also have a community service component, she adds-typically "raking leaves or helping out at the hockey rink or picking up trash."

Mitchell's aim was to make the process for teens arrested on substance charges "more relevant to their offense than picking up trash." With input from Deborah Jantzen, chair of the Diversion Committee, and the Dartmouth Center on Addiction, Recovery, and Education (DCARE), she developed a curriculum that uses 20 hours of the community service commitment for substance abuse-specific activities under the guidance of a DMS student.

The activities she devised include a visit to Lebanon District Court to watch adults deal with substance-related charges such as drunk driving. Observation of an Alcoholics Anonymous, Alateen, or Al-Anon meeting is also on the agenda. Mitchell found that her own visits to such programs in the course of her studies had a profound effect on her attitudes toward drug and alcohol abuse. "Once you see the faces, once you hear stories like that, I don't think you can ever look at the way you drink or the way people around you drink the same way again."

SET has benefits for the volunteer medical student mentors as well as for the teens. They gain experience interacting with adolescents and familiarity with substance-abuse referral options, and they also get to observe the Diversion Committee in action.

Mitchell believes it is important for all medical students to be aware of substance issues. "Whether you go into psychiatry, surgery, or pediatrics," she says, "your patients are going to be affected by substances in some way-the patients themselves or the people around them. It's important to be aware of it and be able to refer patients for treatment or just know what they're going through."

SET, however, is not for every teen arrested on a substance charge. The repeat offender, the addicted teen, the adolescent with a multitude of issues needs more help than medical students can give, notes Mitchell. (If her name sounds familiar, she's also a regular contributor to Dartmouth Medicine and wrote a feature for the last issue on presentations at DHMC by several presidential candidates.)

But in some situations, SET offers just the right approach. "Not every kid that gets caught drinking has a drinking problem," Mitchell says. "There's a certain amount of normal experimentation that goes on among teenagers that may or may not translate into problems with substance abuse down the road."

Teens: With guidance from medical students just a little (but not too much) older, the teens have a chance to reflect on peer pressure, on the way substances are glamorized in the media, and on how they feel at parties where drinking is going on-and, most importantly, on what they can do to keep from being arrested again on a substance charge.

Joyce F. Wagner

If you would like to offer any feedback about this article, we would welcome getting your comments at DartMed@Dartmouth.edu.

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